Register Online About ADPCA About the Conference Invitation Contact Us
Please print this out, fill it in and mail it to: Yoko Allen / ADPCA/ 2865 Shimmering Bay St.,/ Laughlin, NV 89029
Note: Registration scholarships may be available. For more information please contact Yoko at 702/298-9215.
2008 ASSOCIATION FOR THE DEVELOPMENT OF THE PERSON CENTERED APPROACH CONFERENCE REGISTRATION FORM
Name___________________________________________________________ Nevada Professional LIcense if Any_____________
Telephone Day_____________________________ Evening_______________________________
Mailing Address:________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
E-Mail Address:______________________________________________________________________
PRE-CONFERENCE: July 15, 2008 1-5 pm,
Free but space is limited. Please check below if you will attend.
____ The Person-Centered Approach–Past, Present, and Future
presented by Bruce Allen, Ph.D.
CONFERENCE REGISTRATION FEE: Conference begins @ 7 p.m. July 15, 2008
____ $350 registration fee for ADPCA members
____$450 registration fee for non-ADPCA
(Note: You do not have to stay in the dormitory. If you choose to, though, you may check into a dormitory as early as Friday, July 11, 2008 and check out on Sunday, July 20, 2008.)
Date you will be checking in to the dormitory: _______________________________________
Date you will be checking out of the dormitory:______________________________________
Dormitory rooms:_____ $40/person/night Single (shared bathroom) X ____nights=$_____________
______$22/person/night for double. X____nights =$_____________
Roommate requested (if any) __________________________________________________
TOTAL AMOUNT ______________________
(The registration is for room and conference registration only. Food isn't included.)
Please send the registration forms and checks or cash to "ADPCA 2008"
Yoko Allen
ADPCA
2865 Shimmering Bay Street,
Laughlin, NV 89029
USA
If paying by Visa or Mastercard, please indicate which card.
____Visa/
____ Mastercard
Card # _______________________________
Expiration date__________________________________
Signature________________________________________________
If you have any questions, please contact Yoko Allen at (702) 298-9215 or at
adpca@cmaaccess.com.Thanks. See you in Las Vegas!